Insurance Open Enrollment Edition

Educate - Don't Procrastinate!

Open Enrollment is happening now for the new plan year beginning October 1.  See next column for a schedule of meetings - Please avoid phone calls -Bring your questions to a meeting, and learn from others' questions!

 Things to remember:

• We're part of the new state-wide, school employee pool managed under the Oregon Educator Benefits Board (OEBB). You will have a selection of four different medical plans from which to choose.
• Everyone must make an enrollment decision, and enroll on-line via any web-connected computer.
• Computer help is available at each Open Enrollment meeting. Even if you're allergic to computers, just show up to an Open Enrollment meeting, and we'll help you enroll! See back of this page for some "planning ahead" tips.
• Regardless of which medical plan you choose, the medical, prescription, dental, and vision coverage is the same. Keep that in mind when comparing medical plan benefits, versus out-of-pocket costs.
• Absolute deadline is September 15, 2008. Avoid the stress of "last-minute" computer crashes by enrolling before the deadline.

Are you Waiving Insurance?

-not covering a benefits-eligible dependent?

...or a Part-timer Waiving Dental?

Read the back page of this newsletter for important information!

Dependent Eligibility

Enrolled dependent children up to age 26 will be covered provided they meet IRS definition of a dependent child and either

a) attend school full-time, or

 b) live at home over 6 months of the year, and the employee provides over half the yearly support.

Open Enrollment Meeting Schedule

Education Center Auditorium

Please avoid phone calls -Bring your questions to a meeting, and learn from others' questions!

"The Clock" Resets October First

-New Deductibles,

-New Out-of-Pocket Maximums,

-All Tracked on Plan Year:  Oct. 1- Sept. 30

Another big decision by the OEBB board: All tracking for deductibles and maximums will follow the plan year.  This means all tracking for deductibles and out-of-pocket maximums starts anew October 1, 2008 and continues through September 30, 2009. 

This is a change for us, since we are all used to these items re-setting in January of each year.  There are some pros and cons to this change during the first transition year, but overall it makes more sense for deductibles, etc. to coincide with plan year selections.

Planning Ahead for Your Enrollment

Whether you're going to enroll on your computer at home, work, or one of our enrollment meetings, here are several things to keep in mind:

To get started, you will need to be able to identify yourself with either your Social Security number or your 4J employee ID number.

You will need to set up a user name and password for your own private enrollment account.  There are some requirements for you to think about ahead of time on these two items:

User name:  Needs to be at least six characters long, and not longer than 15 characters. 

Password:  Needs to be at least seven characters long, and must contain at least one number and one capital letter.   

By having these details jotted down ahead of time, you'll have a "jump start" on your enrollment!

Important Information on Waivers

Waivers will take place on-line during the enrollment process, so even if don't desire insurance coverage, you must go through the on-line enrollment process.

"Doing nothing" is not an option! 

Also, there are some lower cost options - even a zero-cost option for full-time employee single coverage - so consider your choices before even thinking about waiving coverage.

Read on for important information!

New rule:

If you or a dependent does not enroll in OEBB coverage when first eligible:  It may trigger waiting periods for most vision and dental benefits upon joining the plan at a future enrollment.  The only exception is if you or your dependent lost other coverage and immediately enrolled in OEBB.

What does this mean?

If you're a "part-timer" who waives dental for the 08-09 plan year:

• If you enroll in future years, your dental coverage will only include preventive care (cleaning, fluoride, x-rays per schedule) for the first twelve months. Orthodontia and all other services would be excluded for that twelve month period.

If you waive medical coverage, or an eligible dependent does not enroll when first eligible:

• If you enroll in future years, your dental coverage will have the same limits listed above. In addition, your vision coverage will be limited to an eye exam only (no frames or lenses) for the first twelve months.

What if I waived, or didn't cover a dependent during  this current plan year?

• This is the first year of eligibility for the OEBB plans, so it's an "open door" for all benefits-eligible employees and their eligible dependents.

Anyone who enrolls now will not be subject to these waiting periods.

Pharmacy Refills: To Ease Transition,

 Refill Any Eligible Rx in Late September

Remember, you can refill prescriptions under the current (Regence) plan through September 30.  It's a good idea to refill eligible prescriptions in late September, to ease the transition to the new plan.

If you have a good supply of medications going into the new plan year October 1, that will allow time for your new insurance card to arrive.

If you do need to fill a prescription before your new insurance card arrives, don't worry.  You may have to pay for it up front, but you can submit a receipt to ODS for payment under plan guidelines.

As a rule, you will usually pay the least for Generic drugs.  Preferred Brand drug will usually be more expensive than Generics, and Non-Preferred Brands are the most expensive to you, and to our insurance.

If you'd like to view the ODS Preferred Brand Drug List, go to: 

http://www.oregon.gov/DAS/OEBB/ODS.shtml

Along with some other information links, you can click on the "Preferred Drug List" link at the bottom of that page. You can also call ODS Pharmacy Customer Service at 866-923-0411 for pharmacy and benefit questions.

Mail Order option will be available in October, after we have our insurance cards.  Our next newsletter will address that information.  If you'd like to look ahead on the mail order option, go to:

http://www.odscompanies.com/oebb/mailorder.shtml

This newsletter is reviewed and edited each month by the District 4J and OSEA representatives of the Classified Joint Benefits Committee (JBC).  The information in this newsletter is summarized, and is not intended as advice or counsel.